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Ventilator-associated pneumonia (VAP) is an adverse outcome in critically ill individuals undergoing invasive mechanical ventilation. Oral hygiene is critical for VAP prevention, but the most beneficial approach remains unclear. This study aimed to find the same.
In critically ill patients, brushing combined with 0.12% chlorhexidine appears to be an effective intervention for VAP prevention, with brushing-based oral care emerging as the optimal approach in intensive care unit settings.
Ventilator-associated pneumonia (VAP) is an adverse outcome in critically ill individuals undergoing invasive mechanical ventilation. Oral hygiene is critical for VAP prevention, but the most beneficial approach remains unclear. This study aimed to find the same.
A systematic review and network meta-analysis included parallel randomized controlled trials (RCTs) comparing oral hygiene methods, including antiseptics and toothbrushes, in adults with invasive mechanical ventilation. VAP occurrence was the key outcome ascertained. Bias risk was examined via the Cochrane Risk of Bias 2 tool.
Thirteen RCTs were incorporated into the qualitative synthesis, while 12 RCTs (involving 2,395 participants) were included in the network meta-analysis. Ten oral hygiene interventions were analyzed. Oral hygiene care methods that incorporated brushing illustrated high rankings. Brushing combined with chlorhexidine 0.12% was ranked the highest (88.4%), followed by chlorhexidine 0.12% alone (76.1%) and brushing alone (73.2%).
Combining brushing with 0.12% chlorhexidine may serve as a viable approach to prevent VAP. Additionally, brushing alone could be the most efficient oral hygiene strategy for minimizing VAP risk in the intensive care unit.
PLOS ONE
Comparative efficacy of various oral hygiene care methods in preventing ventilator-associated pneumonia in critically ill patients: A systematic review and network meta-analysis
Sachika Yamakita et al.
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